Usefulness of the left ventricular myocardial contraction fraction in healthy men and women to predict cardiovascular morbidity and mortality.
Usefulness of the left ventricular myocardial contraction fraction in healthy men and women to predict cardiovascular morbidity and mortality.
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DOI：
10.1016/j.amjcard.2012.01.357
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发表时间：
2012-05-15
影响因子：
2.8
通讯作者：
Manning, Warren J.
中科院分区：
文献类型：
--
作者：
Chuang, Michael L.;Gona, Philimon;Salton, Carol J.;Yeon, Susan B.;Kissinger, Kraig V.;Blease, Susan J.;Levy, Daniel;O'Donnell, Christopher J.;Manning, Warren J.
我们试图确定心肌收缩分数（MCF，左心室（LV）每搏输出量与心肌容量之比）降低是否可以预测最初健康成年人的心血管疾病（CVD）事件。弗雷明汉心脏研究后代队列中没有临床 CVD 的子集（N=318，60±9 岁，158 名男性）在 1998 年至 1999 年接受了体积心血管磁共振 (CMR) 成像。测定左心室射血分数 (EF)、质量和 MCF。 “硬”CVD 事件包括心血管死亡、心肌梗塞、中风或新发心力衰竭。使用调整弗雷明汉冠状动脉风险评分 (FCRS) 的 Cox 比例风险模型来估计 MCF、LV 质量和 LVEF 的性别特定四分位数的硬 CVD 事件的风险比。 LV 质量的最低四分位数和 MCF 和 EF 的最高四分位数作为参考。 Kaplan-Meier 生存图和对数秩检验用于比较无事件生存。女性MCF (0.58±0.13) 高于男性(0.52±0.11)，p<0.01。几乎所有 (99%) 参与者的 EF ≥ 0.55。在长达 9 年（中位数 5.2）的随访中，31 名参与者 (10%) 经历了严重 CVD 事件。与最低四分位的 MCF 相比，最低四分位的 MCF 发生硬性 CVD 的可能性高出 7 倍（风险比 7.11，p=0.010），并且即使在调整 LV 质量后，风险仍然升高（风险比=6.09，p=0.020）。最高四分位左心室质量/高度2.7 的风险几乎是五倍（风险比4.68，p=0.016）。最低四分位 MCF 的无事件生存期较短，p = 0.0006，但最低四分位 LVEF 的无事件生存期较短。结论：在最初没有临床 CVD 的成年人队列中，在调整传统 CVD 危险因素和 LV 质量后，最低四分位的 MCF 会增加硬 CVD 事件的风险。
We sought to determine whether depressed myocardial contraction fraction (MCF, the ratio of left ventricular (LV) stroke volume to myocardial volume) predicts cardiovascular disease (CVD) events in initially healthy adults. A subset (N=318, 60±9 yrs, 158 men) of the Framingham Heart Study Offspring cohort free of clinical CVD underwent volumetric cardiovascular magnetic resonance (CMR) imaging in 1998–1999. LV ejection fraction (EF), mass and MCF were determined. “Hard” CVD events comprised cardiovascular death, myocardial infarction, stroke or new heart failure. A Cox proportional hazards model adjusting for Framingham Coronary Risk Score (FCRS) was used to estimate hazard ratios for incident hard CVD events for sex-specific quartiles of MCF, LV mass and LVEF. The lowest quartile of LV mass and highest quartiles of MCF and EF served as referent. Kaplan-Meier survival plots and the log rank test were used to compare event-free survival. MCF was greater in women (0.58±0.13) than men (0.52±0.11), p<0.01. Nearly all (99%) participants had EF ≥ 0.55. Over up to 9-year (median 5.2) follow-up, 31 participants (10%) experienced an incident hard CVD event. Lowest-quartile MCF was 7 times more likely to develop hard CVD (hazard ratio 7.11, p=0.010) compared to the lowest quartile, and the elevated hazards persisted even after adjustment for LV mass (hazard ratio=6.09, p=0.020). The highest-quartile LV mass/height2.7 had nearly five-fold risk (hazard ratio 4.68, p=0.016). Event-free survival was shorter in lowest-quartile MCF, p = 0.0006, but not in lowest-quartile LVEF. Conclusion: In a cohort of adults initially without clinical CVD, lowest-quartile MCF conferred an increased hazard for hard CVD events after adjustment for traditional CVD risk factors and LV mass.
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影响因子：
6.4
作者：
Pruessmann, KP;Weiger, M;Boesiger, P
通讯作者：
Boesiger, P
影响因子：
37.8
作者：
Wilson, PWF;D'Agostino, RB;Kannel, WB
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Kannel, WB
DOI：
10.1016/s0735-1097(02)01944-7
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